Appendix Appendix Figure 1: Trends in age-standardized cardiometabolic (CVD and diabetes) mortality by country.
Men Age standardized cardiometabolic death rate per 100,000 800 700 600 500 400 300 200 800 700 600 500 400 300 200 800 700 600 500 400 300 200 USA 800 700 600 500 400 300 200 Portugal Spain Sweden Switzerland UK Luxembourg Mexico Netherlands New Zealand Chile Denmark Finland France Argentina Australia Austria Year Belgium Norway Greece Ireland Israel Italy Japan Germany Canada 800 700 600 500 400 300 200 800 700 600 500 400 300 200
Women Age standardized cardiometabolic death rate per 100,000 400 300 200 100 400 300 200 100 400 300 200 100 USA 400 300 200 100 Portugal Spain Sweden Switzerland UK Luxembourg Mexico Netherlands New Zealand Greece Ireland Israel Italy Japan Chile Denmark Finland France Argentina Australia Austria Year Belgium Norway Germany Canada 400 300 200 100 400 300 200 100
Appendix Figure 2: Trends in age-standardized lung cancer mortality by country.
Men USA 150 100 50 Portugal Spain Sweden Switzerland UK Age standardized lung cancer death rate per 100,000 150 100 50 150 100 50 Luxembourg Mexico Netherlands New Zealand Norway Greece Ireland Israel Italy Japan Chile Denmark Finland France Germany 150 100 50 150 100 50 Argentina Australia Austria Belgium Canada 150 100 50 Year
Women Age standardized lung cancer death rate per 100,000 70 60 50 40 30 20 10 70 60 50 40 30 20 10 70 60 50 40 30 20 10 USA 70 60 50 40 30 20 10 Portugal Spain Sweden Switzerland UK Luxembourg Mexico Netherlands New Zealand Chile Denmark Finland France Argentina Australia Austria Year Belgium Norway Greece Ireland Israel Italy Japan Germany Canada 70 60 50 40 30 20 10 70 60 50 40 30 20 10
Appendix Figure 3: Trends in age-standardized body mass index (BMI) by country. See Webappendix in Finucane and colleagues for estimated trends and their uncertainty intervals in relation to original country data 1.
Men Body mass index (Kg/m 2 ) 28 27 26 25 24 23 28 27 26 25 24 23 28 27 26 25 24 23 USA 28 27 26 25 24 23 Portugal Spain Sweden Switzerland UK Luxembourg Mexico Netherlands New Zealand Chile Denmark Finland France Argentina Australia Austria Belgium Norway Greece Ireland Israel Italy Japan Germany Canada 28 27 26 25 24 23 28 27 26 25 24 23 Year
Women USA 28 26 24 22 Portugal Spain Sweden Switzerland UK 28 26 24 22 Luxembourg Mexico Netherlands New Zealand Norway Body mass index (Kg/m 2 ) 28 26 24 22 Greece Ireland Israel Italy Japan Chile Denmark Finland France Germany 28 26 24 22 28 26 24 Argentina Australia Austria Belgium Canada 22 28 26 24 22 Year
Appendix Figure 4: Trends in age-standardized systolic blood pressure (SBP) by country. See Webappendix in Danaei and colleagues for estimated trends and their uncertainty intervals in relation to original country data 2.
Men Systolic blood pressure (mm Hg) 140 135 130 125 140 135 130 125 140 135 130 125 USA 140 135 130 125 Portugal Spain Sweden Switzerland UK Luxembourg Mexico Netherlands New Zealand Greece Ireland Israel Italy Japan Chile Denmark Finland France Argentina Australia Austria Year Belgium Norway Germany Canada 140 135 130 125 140 135 130 125
Women USA 135 130 125 120 Portugal Spain Sweden Switzerland UK Systolic blood pressure (mm Hg) 135 130 125 120 135 130 125 120 Luxembourg Mexico Netherlands New Zealand Chile Denmark Finland France Norway Greece Ireland Israel Italy Japan Germany 135 130 125 120 Argentina Australia Austria Belgium Canada 135 130 125 120 135 130 125 120 Year
Appendix Figure 5: Trends in age-standardized total cholesterol (TC) by country. See Webappendix in Farzadfar and colleagues for estimated trends and their uncertainty intervals in relation to original country data 3.
Men USA 6.0 5.5 6.0 5.0 Portugal Spain Sweden Switzerland UK 5.5 5.0 Luxembourg Mexico Netherlands New Zealand Norway Total cholesterol (mmol/l) 6.0 5.5 5.0 Greece Ireland Israel Italy Japan Chile Denmark Finland France Germany 6.0 5.5 5.0 6.0 5.5 Argentina Australia Austria Belgium Canada 5.0 6.0 5.5 5.0 Year
Women USA 6.0 5.5 6.0 5.0 Portugal Spain Sweden Switzerland UK 5.5 5.0 Luxembourg Mexico Netherlands New Zealand Norway Total cholesterol (mmol/l) 6.0 5.5 5.0 Greece Ireland Israel Italy Japan Chile Denmark Finland France Germany 6.0 5.5 5.0 6.0 5.5 Argentina Australia Austria Belgium Canada 5.0 6.0 5.5 5.0 Year
Appendix Figure 6: Cross-country associations between change in risk factors and change in CVD death rate. All variables are age-standardized as described in Methods. Each point shows one country. The lines show the fitted linear association.
Annual change in cardiovascular diseases mortality (%) 6 5 4 3 2 1 0 6 5 4 3 2 1 0 Men ITA GRC ARG CHL AUS MEX ESP USA FRA JPN DEUNLD ITA FIN CHE DNK SWE PRT BEL AUT IRL LUX CAN GBR NOR NZL ISR 0.00 0.05 0.10 0.15 Women GRC SWE FRA BEL CHE FIN JPN DEU AUT ESP NLD DNK PRT LUX NOR IRL 0.00 0.05 0.10 0.15 Annual change in BMI (kg/m 2 ) CAN GBR ISR USA NZL AUS MEX ARG CHL 6 5 4 3 2 1 0 6 5 4 3 2 1 0 USA FIN CHE LUX CAN FRA NLDEU BEL AUT NOR NZL AUS ESP JPN 0.5 0.4 0.3 0.2 0.1 0.0 AUS SWE DNK ITA GBR ISR MEX GRC GRC USA NLD DNK ARG SWE CHL FRA LUX NOR DEU GBR CHE BEL CAN ITA ESP AUT FIN PRT IRL NZL JPN ISR MEX ARG IRL PRT CHL 0.5 0.4 0.3 0.2 0.1 0.0 Annual change in SBP (mm Hg) 6 5 4 3 2 1 0 6 5 4 3 2 1 0 GRC AUS 0.06 0.04 0.02 0.00 0.02 SWE ARG USAESP FRA NLD DEU FIN SWE BEL CHE DNK ITA PRT GBRLUX AUT CANIRL NOR NZL ISR GRC USA AUS NLD DNK ARG GBR LUX NOR FRA CAN DEU CHE BEL AUT ESP FIN NZL IRL ISR PRT ITA MEX CHL CHL MEX JPN JPN 0.06 0.04 0.02 0.00 0.02 Annual change in TC (mmol/l) 6 5 4 3 2 1 0 6 5 4 3 2 1 0 MEX GRC CHL ARG USA ESP FRA JPN NLD DEU FIN CHE BEL DNK ITA SWE PRT GBR LUX AUT CAN IRL NOR NZL ISR AUS 6 4 2 0 2 4 6 MEX GRC USA NLD ARG DNK CHL SWE GBR LUX DEU FRA NOR IRL JPN ISR CAN AUT BEL CHE PRT ITAESP FIN NZL AUS 6 4 2 0 2 4 6 Change in LC (%)
Appendix Table 1: Adjusted associations between change in risk factors and change in cardiometabolic (CVD and diabetes) death rate (Main analysis); between risk factor levels and cardiometabolic death rate (Sensitivity analysis 1); and between the deviations of risk factors and deviations of cardiometabolic death rate in each country from the average of all countries (Sensitivity analysis2). The reported associations are rate ratios; numbers in brackets show 95% confidence intervals. See Appendix Table 2 for association with CVD alone and Appendix Table 3 for results by age group.
BMI (per 1 kg/m 2 ) SBP (per 10 mmhg) TC (per 1 mmol/l) Main analysis Sensitivity analysis 1 Sensitivity analysis 2 Men Women Men Women Men Women 1.06 (0.91, 1.22) 1.06 (0.97, 1.16) 1.02 (0.99, 1.05) 1.06 (1.04, 1.08) 1.02 (0.99, 1.05) 1.06 (1.04, 1.07) 1.85 (1.04, 3.29) 1.68 (0.93, 3.04) 1.40 (1.29, 1.52) 1.49 (1.34, 1.64) 1.40 (1.30, 1.52) 1.49 (1.35, 1.64) 1.26 (0.90, 1.77) 1.22 (0.88, 1.67) 1.33 (1.24, 1.42) 1.16 (1.09, 1.24) 1.33 (1.24, 1.42) 1.16 (1.10, 1.24)
Appendix Table 2: Adjusted associations between change in risk factors and change in CVD death rate. The reported associations are rate ratios; numbers in brackets show 95% confidence intervals.
BMI (per 1 kg/m 2 ) SBP (per 10 mmhg) TC (per 1 mmol/l) Men Women 0.99 (0.85, 1.15) 1.06 (0.92, 1.10) 1.72 (0.95, 3.10) 1.68 (1.01, 3.32) 1.25 (0.89, 1.77) 1.22 (0.83, 1.59)
Appendix Table 3: Adjusted associations between change in risk factors and change in cardiometabolic (CVD and diabetes) death rate by age groups. The reported associations are rate ratios; numbers in brackets show 95% confidence intervals.
25-74 years 45-64 years 65-79 years Men Women Men Women Men Women BMI (per 1 kg/m 2 ) 1.06 (0.91, 1.24) 1.06 (0.97, 1.17) 1.03 (0.87, 1.22) 1.02 (0.92, 1.14) 1.07 (0.93, 1.22) 1.06 (0.97, 1.15) SBP (per 10 mmhg) 1.83 (0.98, 3.42) 1.73 (0.91, 3.28) 1.61 (0.84, 3.09) 1.62 (0.82, 3.20) 1.64 (1.09, 2.46) 1.41 (0.94, 2.13) TC (per 1 mmol/l) 1.39 (0.98, 1.99) 1.32 (0.94, 1.85) 1.53 (1.06, 2.21) 1.24 (0.84, 1.83) 1.13 (0.82, 1.56) 1.16 (0.89, 1.51)
Appendix Table 4: Adjusted associations between change in risk factors and change in cardiometabolic (CVD and diabetes) death rate in the main analysis and in an analysis excluding Mexico. The reported associations are rate ratios; numbers in brackets show 95% confidence intervals.
Main analysis Analysis without Mexico Men Women Men Women BMI (per 1 kg/m 2 ) 1.06 (0.91, 1.22) 1.06 (0.97, 1.16) 0.96 (0.84, 1.1) 1.00 (0.94, 1.07) SBP (per 10 mmhg) 1.85 (1.04, 3.29) 1.68 (0.93, 3.04) 1.57 (0.98, 2.52) 1.82 (1.24, 2.67) TC (per 1 mmol/l) 1.26 (0.90, 1.77) 1.22 (0.88, 1.67) 1.08 (0.44, 2.64) 0.98 (0.78, 1.22)
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